Episode Transcript
Announcer: 来自犹他大学医生和专家的医学新闻和研究，你可以用它来过上更快乐、更健康的生活. You're listening to The Scope.
Interviewer: 如果你看电视，你就无法逃避广告，你需要的广告 testosterone therapy. It looks like it's pretty easy to get, but should you get it? That's the question. Right now I've got with Dr. Tom Miller, University of Utah health care.
Dr. Tom, for a guy that's over 30 years old, 科学证明，睾酮水平在那个时候开始下降. Should I be ordering some of this testosterone online? I mean after all, I want to look like that guy.
Why Testosterone Treatment?
Dr. Tom: I think the question, Scot, is why do you think you need it? What's different?
Scot: So, the ads tell me my energy levels have dropped, which they have, that I start putting on more body weight, that my mood is affected, and my sex drive is decreased. Testosterone is going to cure it. It's kind of cure-all is what they're telling me.
Dr. Tom: That's a great concern. That's a concern of many men, and women, throughout the country, 但真正的问题是，你提到的这些事情是否有不同的原因? 有很多原因导致人们有点超重，感觉有点疲劳. It isn't just testosterone; it's a whole basket full of causes.
Scot: So, if I came into your office, and I gave you those symptoms, and I said that I want testosterone what would you say to me? Where would you start looking?
Dr. Tom: I would ask a few questions. One I'd ask, "What's your sex drive like? Has it dropped off? Are you interested in sex? Do you have the same drive that you had five years ago?如果这个问题的答案是否定的，而且你对此很担心, I'd then go ahead and measure your testosterone level.
Scot: Okay.
Dr. Tom: But I'd also ask you a number of other questions. If the testosterone levels came back low, then we might do a trial of testosterone replacement, and we would then monitor how you felt. 在大发娱乐尝试这种药的过程中，你感觉好些了吗? If not, it might be wise to stop it.
Do I need a Prescription for Testosterone Treatment?
Scot: So, let's back up for a second, these ads that I'm seeing on TV, I can just order without a doctor's prescription?
Dr. Tom: No, you have to have a doctor's prescription. 电话那头有个医生问了一堆问题.
Scot: So, when I make that call, there is a doctor?
Dr. Tom: There's somebody that has to write the prescription.
Scot: Got you. How do they know how much I need, 因为听起来你需要做测试来找出实际的水平? 听起来他们只是问我一些问题，如果我通过了，他们就会给我开处方.
Dr. Tom: That's probably true. 我不能证明他们做的其他事情，我不确定这是获得医疗保健的最好方式. 基本上你告诉他们你需要睾丸素，他们说，“好吧. Answer these questions. Here's your prescription.“我不确定这是定义你的问题的最佳方式. As I mentioned before, 导致疲劳和体重增加的原因有很多，不仅仅是睾丸激素.
Treating the Underlying Cause
Scot: 所以，让大发娱乐假装我进入你，因为我想更聪明一点. You ask me some questions; you decide to run some tests. 你会发现我在正常范围内，在正常范围的低端. Would you do anything at that point?
Dr. Tom: I probably would counsel you about your lack of sexual drive. Well, I'd seek more information about that, 我可能会认为除了睾酮水平处于临界范围之外还有其他原因. I suppose if you really wanted to try it we could do a trial.
Scot: Sure.
Dr. Tom: I'm not opposed to that if the patient thinks that's right, but I try to give them a realistic expectation. Also tell them that, "Look, 如果大发娱乐这样做了几个月，你发现没有什么不同，吃药是不明智的, and you're honest with yourself about it." Just as with any medicine, in my mind, 如果你真的没有从中受益，那么服用它是没有意义的.
What are the Benefits of Testosterone Therapy?
Scot: So, let's take a look at these ads; they promise me so many things. 大发娱乐来谈谈睾丸激素疗法的好处，从严格意义上讲. 作为一个男人，我为什么要来找你，和你谈这件事?
Dr. Tom: Certainly, if you had low levels, it might be affecting your sexual drive, you might have some fatigue, you might have less muscle mass then you were used to. In that instance, if you were replacing testosterone, it might help you quite a bit; you might have a great improvement. 但长期的问题是，大发娱乐不知道副作用 . . . 大发娱乐不知道长期服用超过五年的睾酮替代疗法会有什么副作用. We just don't know that yet.
Risks of Testosterone Therapy
Scot: 所以，这就是现在的风险部分，大发娱乐不知道风险是什么.
Dr. Tom: 大发娱乐真的不知道长期使用睾丸激素的风险是什么. 据我所知，有很多男性的睾丸激素水平很低，但他们并没有察觉到任何差异. 那么，你是否可以通过测试低水平的男性来替代睾丸激素呢? The answer is I don't think we really know. We don't have enough information. 大发娱乐知道睾酮有助于保持骨骼的完整性和强度但大发娱乐还没有说筛查睾酮是一件必须做的事.
Should I Get Screened for Low-T?
Scot: So, it falls off as I turn 30, and as I get older. When you're testing, are you testing for the normal range for, say, a 55-year-old man, if I'm 55, or were you...?
Dr. Tom: I want to back you up a little bit; testosterone may decrease variably in men so it's not the same as menopause in women.
Scot: Okay.
Dr. Tom: 因此，当女性进入更年期时，她们的雌激素水平急剧下降. The same is not uniformly true in men. 随着时间的推移，一些男性的睾丸激素水平会降低，但不是全部. So, it's unclear which men would have low testosterone and others have normal testosterone; we just don't know yet. 并没有建议对所有男性进行睾丸激素水平的筛查.
Scot: 所以，你真的不能说一个50岁的男人应该吃多少?
Dr. Tom: Well that's correct, I mean because we don't screen.
Scot: Got you.
Dr. Tom: 大发娱乐不像检测血压、胆固醇或血糖那样，在年度检查中检测睾丸激素.
Talk to Your Doctor
Scot: 所以，你的建议是不要点电视上的东西因为你在玩的东西...?
Dr. Tom: 我的建议是，如果你对自己的感觉有疑问, 你是否感到疲劳或精力不足或性欲减退, 然后你可能应该和你的医生谈谈，并决定测试你的睾丸激素水平是否适合你. Nothing wrong with that.
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